Follow-up Of 47 Myasthenia Gravis Patients After Thymectomy

Objectives : Myasthenia gravis is an acquired autoimmune disease of the neuro-muscular junction . The rate of prevalence of this disease is about 5/100000.Thymectomy was effective in achieving sustained improvement as well as remission over the last decades.One of the main focuses of current studies is on determine response predicting factors.A long-time follow-up of 52 patients with myasthenia gravis following thymectomy in our institute was carried out to identify prognostic factors and evaluate the outcome of thoracoscope thymectomy.Methods:Clinical records of 52 patients with an established diagnosis of MG who underwent thymectomy since 2005 to 2008 were reviewed.Complete follow-up data were collected and analyzed by proper statistic method.Results:47(90.38%)patients including 28 male and 19 female had a mean age of 35.96土13.98 at the time of operation and a mean follow-up of 21.69士18.26 months.Acorrding to Mordan standard,there was no postoperative mortality. An overall 13 patients remission in symptoms,19 patients improved.13 patients unchange,3 patients worse .Patients' duration of symptoms preoperative correlated with postoperative improvement and remission rates,while sex,age,Osserman Stage ,thymic histology, operation approach are irrelevant . Both thoracoscopic and transsternal approaches to thymectomy in patients with MG are effective in terms of remission, but is less traumatic and better for recovery.The patients with thymoma can increase the incidence of cris. Conclusion: Thymectomy is effective in most myasthenia gravis patients. An early operation is indicated except some children and Ossermen IV patients.Shorter duration of symptoms is related to better outcomes. The thoracoscopic approach is favored and recommended for its safe and less invasive.The authors advocate adopting the approach early.